Active NPI
Roberta A Mittelsted, ARNP
- Family Nurse Practitioner
- Sumner, IA
National Provider Identifier
1245224898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A045501
- Practice address
- 909 W 1St St
Sumner, IA 50674-1203 - Phone
- (563) 578-5375
- Fax
- (563) 578-5437
- NPI assigned
- Sep 8, 2005
- Last updated
- Apr 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A045501 | IA | Primary |
Addresses
Primary practice location
909 W 1St St
Sumner, IA 50674-1203
Mailing address
909 W 1St St
P.O. Box 148
Sumner, IA 50674-1203
Phone (563) 578-5375
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48947 | Other | IA | WELLMARK BCBS |
| 0265751 | Medicaid | IA | |
| I17909 | Other | MEDICARE PART B |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240012800000",
"number": "1245224898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 W 1ST ST",
"address_2": "P.O. BOX 148",
"city": "SUMNER",
"state": "IA",
"postal_code": "506741203",
"telephone_number": "563-578-5375",
"fax_number": "563-578-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 W 1ST ST",
"city": "SUMNER",
"state": "IA",
"postal_code": "506741203",
"telephone_number": "563-578-5375",
"fax_number": "563-578-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITTELSTED",
"first_name": "ROBERTA",
"middle_name": "A",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-08",
"last_updated": "2009-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A045501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "48947",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0265751",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "I17909",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sumner, IA
- Kelly D Shea Inc.
- Kelsey Lynn Kerns, DPT
- Paul Robert McHone, P.T.A.
- MCLD Corporation (Sumner Pharmacy)
- Lonny D Miller, MD
- Northeast Iowa Rural Care Solutions (Slainte Foundation dba Northeast Iowa Rural Care Solutions)
- Northland Hearing Centers, Inc. (Hearing Unlimited)
- P and B Eye Care, LLC
- Janice Maureen Pleggenkuhle, RD LD
- Ann E Reid, PAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.